HEALTH IMPACT AND COST-EFFECTIVENESS OF DIGITAL MESSAGING NUDGES ON INFLUENZA VACCINE UPTAKE AMONG CHINESE OLDER ADULTS: A REAL-WORLD TRIAL
Author(s)
Shouchuang Zhang, PhD1, Siqi Liu, MS2, Chen Chen, PhD1, Yanrong Han, MPH3, Xiaofeng Wang, BS3, Kai Ren, BS3, Weiyan Jian, PhD1, Jing Guo, PhD1.
1Department of Health Policy and Management, School of Public Health, Peking University, Beijing, China, 2AI Thrust, Information Hub, The Hong Kong University of Science and Technology-Guangzhou Campus, Guangzhou, China, 3Ronghua Community Health Center, Beijing, China.
1Department of Health Policy and Management, School of Public Health, Peking University, Beijing, China, 2AI Thrust, Information Hub, The Hong Kong University of Science and Technology-Guangzhou Campus, Guangzhou, China, 3Ronghua Community Health Center, Beijing, China.
OBJECTIVES: Influenza vaccination coverage among older adults remains low in China. Digital messaging nudges offer a scalable approach to improve vaccination uptake, yet their comparative effectiveness and economic value in real-world primary care settings remain insufficiently understood.
METHODS: A digital messaging nudge trial was conducted among adults aged 60 years and older at a community health center in China. Participants were assigned to a control group or six digital messaging nudge groups. The primary outcome was influenza vaccination. Multivariable logistic regression and economic evaluations from a societal perspective were performed.
RESULTS: A total of 6,964 participants were included. Vaccination uptake was higher in the loss-framed message group than in the control group (14.39% vs. 11.21%; adjusted OR: 1.34, 95% CI: 1.02 to 1.76) and in the social comparison message group (14.19% vs. 11.21%; adjusted OR: 1.35, 95% CI: 1.03 to 1.78). The incremental cost-effectiveness ratios were 11.59 (95% CI: 3.42 to 32.40) and 12.97 (95% CI: 1.36 to 42.56) USD per percentage-point increase in vaccination uptake. The incremental cost-utility ratios were 12,062.19 (95% CI: 3588.49 to 33,598.69) and 13,615.90 USD (95% CI: 1427.78 to 44,482.98) per quality-adjusted life year (QALY) gained. Both nudges generated QALY gained of 0.0000305 and 0.0000291 and reduced expected medical costs of 0.36 and 0.35 USD per person, respectively.
CONCLUSIONS: Digital messaging nudges can effectively and cost-effectively improve influenza vaccination uptake among older adults. Loss-framed and social comparison strategies represent scalable approaches with favourable economic value for increasing vaccination coverage.
METHODS: A digital messaging nudge trial was conducted among adults aged 60 years and older at a community health center in China. Participants were assigned to a control group or six digital messaging nudge groups. The primary outcome was influenza vaccination. Multivariable logistic regression and economic evaluations from a societal perspective were performed.
RESULTS: A total of 6,964 participants were included. Vaccination uptake was higher in the loss-framed message group than in the control group (14.39% vs. 11.21%; adjusted OR: 1.34, 95% CI: 1.02 to 1.76) and in the social comparison message group (14.19% vs. 11.21%; adjusted OR: 1.35, 95% CI: 1.03 to 1.78). The incremental cost-effectiveness ratios were 11.59 (95% CI: 3.42 to 32.40) and 12.97 (95% CI: 1.36 to 42.56) USD per percentage-point increase in vaccination uptake. The incremental cost-utility ratios were 12,062.19 (95% CI: 3588.49 to 33,598.69) and 13,615.90 USD (95% CI: 1427.78 to 44,482.98) per quality-adjusted life year (QALY) gained. Both nudges generated QALY gained of 0.0000305 and 0.0000291 and reduced expected medical costs of 0.36 and 0.35 USD per person, respectively.
CONCLUSIONS: Digital messaging nudges can effectively and cost-effectively improve influenza vaccination uptake among older adults. Loss-framed and social comparison strategies represent scalable approaches with favourable economic value for increasing vaccination coverage.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE143
Topic
Economic Evaluation, Epidemiology & Public Health, Health Technology Assessment
Topic Subcategory
Trial-Based Economic Evaluation
Disease
Geriatrics, Vaccines